Fertility and Miscarriage Incidence After Cervical Intraepithelial Neoplasia Treatment by Thermal Ablation : A Cohort Study

Article Article scientifique Article Fertility and Miscarriage Incidence After Cervical Intraepithelial Neoplasia Treatment by Thermal Ablation : A Cohort Study eng 2024-09-16 2025-01 author Wisniak Ania 0000-0002-3942-2134 Department of Gynecology, Obstetrics and Pediatrics, Geneva University Hospitals, Geneva, Switzerland.,Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 717179 author Yakam Virginie Department of Gynecology and Obstetrics, Dschang Regional Hospital Annex, Dschang, Cameroon. author Evina Bolo Sophie Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 939215 author Datchoua Moukam Alida Manoela 0009-0009-2761-5025 Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Gynecology and Obstetrics, Dschang Regional Hospital Annex, Dschang, Cameroon. 405513 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Sormani Jessica 0000-0001-7111-3975 Department of Gynecology, Obstetrics and Pediatrics, Geneva University Hospitals, Geneva, Switzerland.,Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Geneva, Switzerland. 689966 author Vassilakos Pierre Department of Gynecology, Obstetrics and Pediatrics, Geneva University Hospitals, Geneva, Switzerland. 25351 author Kenfack Bruno Department of Gynecology and Obstetrics, Dschang Regional Hospital Annex, Dschang, Cameroon.,Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon. author Petignat Patrick Department of Gynecology, Obstetrics and Pediatrics, Geneva University Hospitals, Geneva, Switzerland. 586685 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 167-177 10.1111/1471-0528.17954 39279637 1470-0328 PMC11625656 https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17954 Objective: To assess the impact of thermal ablation (TA) for the treatment of cervical dysplasia on fertility and pregnancy outcomes among women screened for cervical cancer in Cameroon. Design: Retrospective cohort study. Setting: Dschang health district, Cameroon. Population: Participants aged 30-45 years from two screening trials conducted between 2015 and 2020 in Dschang District Hospital. Methods: Participants were primarily screened for human papillomavirus infection, triaged by visual inspection and treated by TA if needed. Between October 2021 and March 2022, interviews on subsequent fertility were conducted with participants treated by TA and a control group of untreated women. Main outcome measures: Pregnancy and miscarriage after screening/treatment. Results: A total of 760 participants (219 treated and 541 untreated) completed the survey, with a mean follow-up time of 1297 days. Sixty-two women (28.3%) treated by TA reported a pregnancy postscreening versus 165 (30.5%) in the control group (p = 0.550). Adjusted for potential confounders, the hazard ratio of pregnancy for treated compared with untreated women was 0.82 (0.54-1.24, p = 0.350). Among women reporting pregnancies with a known outcome and which were not voluntarily terminated, 18 (35.3%) treated participants had a miscarriage versus 31 (21.4%) in the control group (p = 0.048). In the adjusted model, no association remained between TA and miscarriage (1.04, 0.39-2.78, p = 0.935). Conclusions: In our study population, TA did not significantly impact fertility nor miscarriage risk. Our results support the widespread use of TA as a treatment of choice for precancerous cervical lesions in low-income settings. Cervical cancer Fertility Miscarriage Pregnancy Screening Thermal ablation Humans Female Uterine Cervical Dysplasia / surgery Uterine Cervical Dysplasia / epidemiology Adult Abortion, Spontaneous / epidemiology Retrospective Studies Uterine Cervical Neoplasms / surgery Uterine Cervical Neoplasms / epidemiology Middle Aged Cameroon / epidemiology Incidence Cohort Studies Pregnancy Outcome Ablation Techniques Dewey 613 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 66 Institut de santé globale 22A1 false 590 Prévention du cancer du col utérin 933 BJOG 132 2 3d8dee29-75f8-4c4b-a754-b0d4caec562a Article (Published version) Public Article_scientifique_from_europePmc.pdf 718870 application/pdf CC BY-NC-ND-4.0 2c0597f0156a95f22d2eda3b796dfafbea52d48a08242f128d0a15f7ee9ba91d 3e8de460-f9e6-4e8c-b2b8-04ddbd03ef2b Appendix Public BJO-132-167-s001.docx 115650 application/vnd.openxmlformats-officedocument.wordprocessingml.document dd1cfad1d00b9599f4b11c62d7ea8847405767b41d321c1eb8b166310fe6d6e2 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale

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Fertility and Miscarriage Incidence After Cervical Intraepithelial Neoplasia Treatment by Thermal Ablation : A Cohort Study	BJOG			2025	30	445

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